KMAP BULLETIN: Updated - HCBS Rate Increase for Fiscal Year 2026
Date: 07/23/25
KMAP GENERAL BULLETIN 25122 (PDF)-Updated
Effective with dates of service on or after July 1, 2025, and for the state fiscal year (SFY) 2026, the fees for the Home and Community Based Services (HCBS) and Managed Care Floor rates will increase.
The updated rates for HCBS reimbursement are listed below:
| Brain Injury (BI) | ||
|---|---|---|
| Procedure Code | SFY 2026 Rate | Unit Definition |
| 97535 | $25.00 | 15 minutes |
| 97537 | $25.00 | 15 minutes |
| G0151 | $25.00 | 15 minutes |
| G0152 | $25.00 | 15 minutes |
| G0153 | $25.00 | 15 minutes |
| H0004 | $25.00 | 15 minutes |
| Technology Assisted (TA) | ||
|---|---|---|
| Procedure Code | SFY 2026 Rate | Unit Definition |
| T1000 | $13.75 | 15 minutes |
| Intellectual/Development Disabilities (I/DD) | ||
|---|---|---|
| Procedure Code | SFY 2026 Rate | Unit Definition |
| H0045 | $115.74 | |
| H2023 | $10.16 | 15 minutes |
| S5125 | $5.04 | 15 minutes |
| S5161 | $22.17 | 1 Month |
| S5190 | $51.74 | 1 Visit |
| T1000 | $13.75 | 15 minutes |
| T1019 | $4.43 | 15 minutes |
| T2016 (Residential - Regular Tier 1) | $236.81 | 1 Day |
| T2016 (Residential – Regular Tier 2) | $193.97 | 1 Day |
| T2016 (Residential – Regular Tier 3) | $140.22 | 1 Day |
| T2016 (Residential – Regular Tier 4) | $90.55 | 1 Day |
| T2016 (Residential – Regular Tier 5) | $65.44 | 1 Day |
| T2016 (Super Tier 1) | $283.87 | 1 Day |
| T2016 (Super Tier 2) | $253.30 | 1 Day |
| T2016 (Super Tier 3) | $225.51 | 1 Day |
| T2016 (Super Tier 4) | $197.69 | 1 Day |
| T2016 (Super Tier 5) | $169.32 | 1 Day |
| T2021 (Day Services – Regular Tier 1) | $7.36 | 15 minutes |
| T2021 (Day Services – Regular Tier 2) | $5.44 | 15 minutes |
| T2021 (Day Services – Regular Tier 3) | $4.38 | 15 minutes |
| T2021 (Day Services – Regular Tier 4) | $3.23 | 15 minutes |
| T2021 (Day Services – Regular Tier 5) | $2.77 | 15 minutes |
| T2021 (Super Tier 1) | $8.93 | 15 minutes |
| T2021 (Super Tier 2) | $8.23 | 15 minutes |
| T2021 (Super Tier 3) | $7.57 | 15 minutes |
| T2021 (Super Tier 4) | $6.91 | 15 minutes |
| T2021 (Super Tier 5) | $6.32 | 15 minutes |
| T2025 | $115.74 | Up to |
| T2040 U2 | $173.39 | 1 Month |
Note: The rates noted in this bulletin are subject to future changes. Providers should check the Kansas Medical Assistance Program (KMAP) website for the most up-to-date rates.Note: The effective date of the policy is July 1, 2025. The implementation of State policy by the KanCare Managed Care Organizations (MCOs) may vary from the date noted in the KMAP bulletins. The KanCare Open Claims Resolution Log on the KMAP Bulletins page documents the MCO system status for policy implementation and any associated reprocessing completion dates once the policy is implemented.